The Star PETALING JAYA: If a “special” candy, chocolate or coffee carries steamy images on its packaging and a promise to turn you into some kind of “superman,” beware.
Syndicates are increasingly using food products and supplements to market active ingredients of prescription drugs like Cialis, Viagra and Levitra which are used to treat impotence in men.
The ingredient drugs tadanafil, sildenafil and verdenafil can be harmful to health if taken without proper consultation and dosing and can even cause loss of vision, according to the Pharmaceutical Services Division of the Health Ministry. Director of pharmacy enforcement Mohd Hatta Ahmad said: “The syndicates used to add the drugs into traditional medicines and other medications used purportedly for men's health. Because our control on drugs is quite stringent, they have changed tactics and now lace food products with these ingredients,” he added.
Saturday, December 31, 2011
Sweets and chocolates now being laced with prescription drugs
Friday, December 30, 2011
Health Ministry proceeds with set-up despite resistance against having a nurse-run establishment
Malay Mail SUBANG JAYA: The Health Ministry will set up a 1Malaysia clinic to serve Subang Jaya residents despite opposition against the move.
The residents, led by state assemblyman Hannah Yeoh, have expressed concern over whether nurses and health assistants at 1Malaysia clinics were in the position to legally treat patients and prescribe medication.
They want a government health clinic, run by a qualified doctor and medical staff, instead.
Deputy Health Minister Datuk Rosnah Abdul Rashid Shirlin said she was aware of the residents’ concerns and said the ministry had studied and discussed these issues with various government agencies and non-governmental organisations.
However, Rosnah said the 1Malaysia clinic would serve its purpose for residents in USJ and the surrounding areas.
“The ministry had previously set up a health clinic in Medan Maju Jaya in March 2007, which serves the surrounding areas, including Bandar Sunway,” she said.
“Subang Jaya residents can also seek medical attention from the health clinic in Medan Maju besides the other clinics in Kelana Jaya and Puchong.”
Yeoh said she was disappointed the ministry was going ahead with its plan to set up the 1Malaysia clinic.
“I have raised the matter with the relevant authorities and the ministry on several occasions but to no avail,” she said.
“There is already an allocation under the Ninth Malaysia Plan for the construction of a government clinic that will be able to operate like any other health clinic with qualified doctors and medical staff to serve the needs of the public.”
She also said the Subang Jaya Municipal Council (MPSJ) had identified a suitable plot of land in USJ 1 for the construction of such a health clinic.
Last week, Yeoh accompanied members of the Subang Jaya senior citizens club to a meeting with ministry officials to discuss problems faced by the residents seeking treatment at nearby health clinics.
She said the clinics already served densely-populated areas and the residents would prefer to seek treatment “in their own area”.
Yeoh said in addition to having to wait for long periods, some of the residents had to stand for hours because of the lack of chairs.
Rosnah said there should not be any problem for senior citizens to collect their medicines as it could be done by their spouses or children.
1Malaysia clinics were first set up more than a year ago.
Since the announcement by Prime Minister Datuk Seri Najib Razak of a RM10 million budget allocated for the project, 50 such clinics have been established throughout the country.
Talks on safe nitrate level in bird's nest underway
The Sun Daily A GROUP of Chinese health officials arrived in Malaysia on Monday for talks with their Malaysian counterparts to determine the permissible level of nitrite in bird's nest, China Press reported today.
It is understood that the Health Ministry wants to keep a low profile on the talks and has not sought media coverage.
During his visit to China early last month, Health Minister Datuk Seri Liow Tiong Lai had invited Chinese health officials for talks in order to reach an agreement on the level of nitrite allowed for Malaysian bird's nest bound for the Chinese market.
This followed the Chinese authorities' imposition of the zero ppm (part per million) nitrite in bird's nest products, which practically barred all bird's nest products from Malaysia.
Following his Chinese trip, Liow had said the Chinese authorities would allow the presence of natural nitrite in bird's nest products but will not permit nitrite additives in these products.
He also said both sides had set up a working committee comprising food specialists and experts to determine the permissible level of nitrite in bird's nest products.
It is understood that the working committee has completed its task early this month.
Malaysia can resume bird's nest export to China as soon as both sides reach an agreement on the nitrite standard.
Wednesday, December 28, 2011
Scientific breakthrough
NST RESEARCHERS at Universiti Teknologi Mara (UiTM) have successfully mapped the Malay genome, a scientific breakthrough which is expected to generate billions of ringgit for the biotechnology and pharmaceutical industries. This quantum leap in the field of genomics paves the way for personalised or specific medicine to be developed for the Southeast Asian population as the Malay genome is the gene composition of not only Malaysians but also Indonesians, Thais and Filipinos.
Malaysian Biotech Corporation (BiotechCorp) chief executive officer Mohd Nazlee Kamal said mapping the genome could generate “around RM2 billion per annum”.
“The ethnic Malay population numbers some 200 million in Southeast Asia — Malaysia, Indonesia, Thailand and the Philippines. “The region is seen as a lucrative market as the people are growing in terms of wealth.
“The Malay genome, therefore, is very valuable to drug companies in developing personalised medicines which are more effective as they are targeted at those who share similar genetic traits.
“Most of the medicines developed now are not suitable for the local population as they are designed for the European market,” he said after the findings were announced by Deputy Prime Minister Tan Sri Muhyiddin Yassin at UiTM’s Puncak Alam campus yesterday. Muhyiddin, who also launched the BioNexus Partners network programme between BiotechCorp and UiTM, said developing personalised medicine could spur a high-income biotechnology and pharmaceutical research industry.
“It is a well-known fact that genes play a role in determining one’s risks to certain diseases and how they respond to different types of medicine. “This is similar to efforts being carried out in developed nations which are using genetic knowledge to develop suitable health strategies for local populations."
Led by researchers at UiTM's Pharmacogenomics Centre (Promise), the genome was mapped by studying three generations of Malay families, using techniques similar to those used to identify Caucasian and Japanese genomes. The RM150,000 project, fully funded by UiTM using equipment and technology provided by BiotechCorp, began in June last year and took nearly seven months to complete.
"It is an encouraging development, especially now that biotech has been targeted as a potentially high-income industry under the National Key Result Area," Muhyiddin said. He said BiotechCorp, the country's leading biotechnology agency, had facilitated the development of 207 BioNexus-status companies with an approved investment of RM2.118 billion, with three per cent of the companies already listed on the Malaysian, Australian and European stock exchanges.
Muhyiddin also said private and public institutions of higher learning had to date produced 16,000 graduates in the life sciences. They were expected to reap the benefits of the National Biotechnology Programme, aimed at generating an 80,000-strong workforce in the biotechnology sector by 2020, he added.
Promise head and lead scientist Prof Mohd Zaki Salleh said the study of the Malay genome would be made available on the Human Genome Project database so that it would be accessible to interested researchers. He also revealed that the Higher Education Ministry had approved a RM8 million grant for further research into six Orang Asli populations, whose numbers have dwindled to below 500 in the country.
"We would like to study the cause of their dwindling numbers as well as to verify a theory posed by several international studies which claim that the Orang Asli are the second-oldest aborigines after the African tribes. "If proven, this could be another breakthrough in terms of creating new avenues for research and changing long-held theories in population studies and migration patterns."
Tuesday, December 27, 2011
Benchmark OSH initiatives against developed countries
National Institute of Occupational Safety and Health (NIOSH) chairman Tan Sri Lee Lam Thye said it was a good benchmark as they (practitioners of OSH in developed countries) only have between three and four accidents per 1,000 workers.
Lee said while Malaysia’s industrial accident rate had been halved over the past 10 years, the challenge remained working towards an accident-free workplace environment.
And for that to happen, Lee stressed that employers must fully appreciate the utmost important of managing OSH towards business competitiveness.
They must see training as an investment, rather than an expense.
“Human Resources Minister Datuk Seri Dr S Subramanian has disclosed that the industrial accident rate had fallen from 10.3 cases for every 1,000 workers to 5.72 last year.
“Although the country’s industrial accident rate has been halved over the past 10 years, the remaining challenge is to build and foster an OSH culture in Malaysia which strives towards an accident-free workplace environment.
“For a start, we need to benchmark ourselves against developed countries, which only have between three and four accidents per 1,000 workers,” Lee said in a statement.
The Occupational Safety and Health Master Plan 2010-2015 must be given its due attention by all parties concerned to achieve further reduction in the industrial accident rate, he stressed.
Companies, he added, must not profit at the expense of safety because if accidents occur lives may be lost and productivity will be affected.
“Managing OSH towards business competitiveness is of utmost importance, and employers must see training as an investment rather than an expense.
“Management or employers must recognise OSH of employees as an integral part of business management. Concerns for the bottom line must be looked at with equal gravity with OSH issues at the workplace. After all, they are both concerned with the
viability of the business enterprise.”
Employees are often regarded by management to be most important asset of any organisation, and hence, they should be protected in terms of safety and health, he asserted.
Lee added: “An accident prevention coupled with the OSH management strategy should, therefore, be adopted by all companies.
“To achieve the total promotion of OSH at the workplace and elsewhere, organisational measures for accident
prevention, motivation, and behavioural change must be adopted.”
And to move in that direction, management must ensure that safety is embedded as a culture in their organisation and
not just a priority, he pointed out.
“We must avoid a situation where behind all the OSH banners and signages, workplace hazards are not addressed and controlled.”
No reason for delay in getting a government clinic
NST SUBANG Jaya assemblyman Hannah Yeoh is urging the Health Ministry to give priority to the setting up of a government clinic in the township.
Yeoh said there should be no reason for the delay as there is an allocation under the Ninth Malaysia Plan and the Subang Jaya Municipal Council had identified a plot of land in USJ 1 for the construction of the clinic.
Without a government clinic in Subang Jaya, residents of Subang Jaya, Bandar Sunway and USJ are forced to seek medical treatment in government clinics as far as Kelana Jaya and Puchong.
Yeoh said in December 2009, the council had given permission to the Petaling district health department to build a government clinic and had allocated a plot of land measuring 0.3ha at USJ 1/33 in Taman Subang Permai.
However, Yeoh said the ministry refused to build it as it claimed it was not suitable during a site visit in early last year.
Seeing the urgency for a government clinic, Yeoh scouted for another site herself. She suggested that it was also feasible to acquire brand new shop lots in USJ 1 to set up the government clinic. The ministry officers assured Yeoh that they would submit the suggestion but she has heard nothing from them till now. During a dialogue with members of the Senior Citizens Club Subang Jaya and ministry officers last week, Yeoh said grouses were raised.
"The nearest government clinic to Subang Jaya is in Kelana Jaya.
"The club members complained about having to go there very early in the morning and waiting in a long queue. On top of that, there aren't enough chairs for them to sit while waiting.
"Because they are given medicines which will only last a month, they have to repeat the tedious process monthly. For Subang Jaya folk to have their own clinic makes sense," she said.
After the dialogue concluded, Yeoh, along with ministry officers, visited the USJ1 site and she was promised that a push would be given for the government clinic to materialise.
"Health Minister Datuk Seri Liow Tiong Lai should know that Selangor folk are also tax payers and they contribute RM16 billion to the Federal Government's revenue.
"They have a right to a government clinic and they ought to benefit from the services.
"Having Subang Jaya folk travel to Kelana Jaya to seek medical treatment only adds on to the number of patients there.
"In Subang Jaya, a plot of land has already been identified. If it is small, then just build a small clinic with basic facilities.
"I hope the focus will not be too much on the infrastructure aspect but on providing service to the people, which should be paramount. We do not need a state-of-the-art government clinic," she said.
The government clinic, added Yeoh, is to benefit senior citizens, urban poor, single parents, students and those living below the poverty line. Over at the Angsana low-cost flats alone, Yeoh said there are 8,000 households
Beauty trade needs laws
The Star PUTRAJAYA: Consumer groups and doctors are calling for laws, instead of guidelines, to curb unethical practices in the beauty industry.
The Health Ministry is expected to come out with a set of guidelines soon.
“We welcome the Health Ministry’s initiative but guidelines are not enough,” said National Consumer Complaints Centre (NCCC) senior manager Matheevani Marathandan.
“I believe the best way to protect consumers from unethical practices is through a legal framework, accompanied by serious enforcement and a proper redress structure under the Health Ministry,” said Matheevani.
“It’s a known fact that guidelines do not have enough bite,” wrote Consumers Association of Penang president, S.M. Mohamed Idris, in response to The Star’s report on the new guidelines.
Mohamed Idris said that if there are only guidelines, consumers would have to take legal action or seek monetary redress from the Consumer Claims Tribunal.
Consultant plastic surgeon Dr Lee Kim Siea thinks there should be some form of punitive measures incorporated into the new guidelines. “Otherwise, who cares? I’ve seen a number of patients who suffered from these problems, and treatment for botched jobs are usually difficult and sometimes impossible,” said Dr Lee.
Sunday, December 25, 2011
Malaysians having fewer children
Minister in the Prime Minister’s Department Tan Sri Nor Mohamed Yakcop, in making public the National Census Report 2010 here yesterday, said the birth rate trend had been on the decline since 2000.
He said economic reasons, women getting married late, and education and career were among the factors leading to the declining birth rate.
“If you look at the figures, an average of 2.2 children a family means we are producing replacement members of society," he said.
"The government is not worried about this though as 67.5 per cent of Malaysians are within the productive age of between 15 and 64 years old.
“We estimate Malaysia will have its maximum population of 57 million by 2090. The reason for the decline is probably due to women having the option of choosing how many children they want to have and also technology and contraceptives to ensure they achieve their target."
On top of that, the present marrying age for women is 26 compared to 23 in 2000, making it another contributing factor to the fall in the birth rate.
Nor Mohamed said the ethnic breakdown by the Statistics Department showed bumiputras having 2.6 children in 2010 compared with 3.5 in 2000, Chinese 1.5 (2.6 in 2000) and Indians 1.7 (2.5 in 2000).
"There were 475,816 babies born last year, compared with 549,543 in 2000," he said.
Meanwhile, Federation of Reproductive Health Associations Malaysia (FRHAM) family planning and reproductive officer Kalpana Devi said one of the reasons for the decline was that couples were marrying at an older age.
Baby formula pulled off US shelves not sold here
Health director-general Datuk Seri Dr Hasan Abdul Rahman said that Mead Johnson Malaysia, the Malaysian branch of the formula's manufacturer, had stressed that the affected product was not imported into Malaysia.
“We have also confirmed this through the Food Safety Information System of Malaysia,” he said in a statement yesterday.
As a precaution, Dr Hasan said the ministry would subject Enfamil baby formula products to a Level 5 examination (Hold, Test and Release) if they were imported.
Dr Hasan was responding to online reports about last Sunday's death of a Missouri newborn who drank the formula, which prompted US retailers to pull the products off their shelves.
Friday, December 23, 2011
No need to fear bird flu here, says D-G
Health director-general Dr Hasan Abdul Rahman said in a statement that the Mini-stry was prepared for influenza pandemics as it had the National Influenza Pandemic Preparedness Plan (NIPPP) in place since 2006.
He said the Health Ministry and the Veterinary Services Department had not detected any infections of Influenza A(H5N1) in humans or chickens in the country.
The Influenza A(H5N1) virus is the causative agent of the H5N1 flu, commonly known as “avian influenza” or “bird flu”.
Hong Kong health authorities has raised its bird flu alert level to “serious” and began culling 17,000 chickens after three birds tested positive for the H5N1 virus.
The Hong Kong Government has also suspended imports of live chickens from mainland China and the trading of live chickens for 21 days.
Pharmaniaga acquires Boustead’s pharma divisions
This will mean all pharmaceutical divisions under Boustead will be transferred to Pharmaniaga, largest integrated local healthcare company in Malaysia.
A subsidiary of Boustead Holdings Bhd, Pharmaniaga Bhd will see RM95 million capex allocation for the next year.
Pharmaniaga managing director Datuk Farshila Emran (pic) said: “Out of this amount, one-third will go towards its pharmacy information system.
She added: “Pharmaniaga plans to spend about RM30 million between 2012 and 2015 for its Sungai Petani plant expansion project and to upgrade equipment and facilities.”
"We are also looking at pumping RM23 million into the construction of a new plant in Perak, as well as, to expand the existing plant in Seri Iskandar, Perak," Farshila told reporters after the extraordinary general meeting (EGM) of Boustead Holdings and Pharmaniaga yesterday.
The EGM saw shareholders agreeing to the acquisition of two other Boustead's pharma divisions by Pharmaniaga.
Some of the developments the company has seen in the last year is the reduction of concession delivery from 60 days to seven days for West Malaysia and 10 days for East Malaysia.
Boustead Holdings Bhd deputy chairman and group managing director Tan Sri Datuk Lodin Wok Kamaruddin said Pharmaniaga would contribute about 10% to Boustead's bottomline beginning next year and this was expected to increase gradually to 15% over the next two to three years.
"The health sector, including pharmaceuticals, is one of the 12 National Key Economic Areas. We believe the prospects and future for the pharmaceutical business is going to be good," he said.
Pharmaniaga, the largest integrated local healthcare company holds a 10-year concession to purchase, store, supply and distribute pharmaceuticals and medical products to 3,750 government hospitals and clinics nationwide.
Pharmaniaga’s book value is worth some RM900 million a year.
Thursday, December 22, 2011
Accidents At Work Places Has Continued To Drop Since 2000 - Subramaniam
Subramaniam said the accident rate was 10.3 cases per 1,000 workers in 2000 and the current rate was almost a 50 per cent drop.
"Syabas Malaysia. This clearly shows that efforts, programmes and campaigns carried out by the government, employers and employees had succeeded.
"I want efforts to be doubled in order to achieve the accident rates registered by developed countries," he said at the National Excellent Health and Safety Awards 2011 here Wednesday.
Subramaniam urged the National Council of Occupational Safety and Health (NCOSH) and Department of Occupational Safety and Health to look at other alternatives like the Blue Ocean Strategy to continue reducing accidents at work places.
"We need alternative strategies to improve the level of safety and health of workers in order to reduce accidents," he said.
Subramaniam hoped the awards would continue to inspire workers to raise their level of safety and health at their respective work places.
One hundred and forty-four organisations nationwide involved in various sectors took part in the awards ceremony this year and 21 organisations and individuals received awards.
Mercy opens mum-baby project in Medan
The project, set up on Saturday in Serdang Berdagai district, aims to improve maternal health and reduce the child mortality rate in the country by 2015.
A joint effort with the North Sumatra Health Services Department, Mercy president Datuk Dr Ahmad Faizal Mohd Perdaus said he hoped to highlight mother and baby health care in Indonesia as the country was the third highest in maternal and infant mortality rates among Asean member countries.
"The mother and child health rate is important in determining the health status of a country," he said, adding that Mercy would set up an office in Indonesia to assist in relief operations.
He said healthcare among pregnant women and midwives should also be given more focus.
"They are already at risk in contracting diseases such as malaria," he said, adding that the prevention of HIV/AIDS from mother to child still had not been dealt with.
Objectives of the programme include increasing human lifespan to 72 years; reducing the infant mortality rate to 24 out of a thousand; reducing the prevalence of child malnutrition to 15 per cent; improving midwifery skills capacity to minimise the number of maternal and infant deaths (ability for normal delivery); and protecting the environment from contamination due to poor sanitation.
"Mercy and its local partners will be monitoring the programme with frequent field visits at targeted areas to ensure its effectiveness."
To reach the MDGs target, Mercy donated RM240,000 to four districts involved in the programme, namely Medan, Langkat, Asahan and Serdang Bedagai, which would benefit 109,442 expectant mothers and 99,493 babies.
The launch, at Pantai Cermin, included activities such as mother and child medical checkups, infant and mother weighing, vaccination, and nutritional checks.
"I want to thank the organisers for contributing funds to help us and our children," Sariyanti Saiful Alam Syah, a 34-year-old who was at the launch with her third child.
Siti Khadijah Sahril, 20, who was with her year-old son, Rizke Wira Tama, said she was grateful for the medical checkups.
Earlier in the week, a memorandum of understanding (MoU) was signed between Mercy and Indonesia to establish a sustainable development programme for healthcare provision.
The MoU signing event also hoped to strengthen the long-term relationship between the countries.
IJN introduces new treatment for leaking mitral valve
IJN chief executive officer Tan Sri Dr Rabaayah Zambahari said the method involved the use of a special 2mm clip, which will be inserted into the heart through the leg vein.
A catheter will be used to guide and deploy the clip into the heart which requires at least three specialist doctors to manoeuvre it, she told a media briefing on the new method at IJN here.
"Once the position is confirmed, the clip will be released from the cable and it would narrow the size of the mitral valve opening and, therefore, correcting the leakage," she said.
Dr Rabaayah said mitral valve leak forces the heart to work harder than normal and if left untreated, could result in heart failure. She said seven patients had gone through the new procedure and the recovery process was speedy, between two to four days, compared to surgery which required seven days.
"The new method provides an option for patients who do not want to undergo an open heart surgery. The new method is safe," she said, adding that the treatment would cost at least RM150,000 per patient.
Are you getting the best possible treatment?
Its president, Dr Steven Chow, said the independence of doctors in treating patients are often compromised due to contracts with third party private healthcare facilities in breach of doctors’ code of conduct.
“Over the years, we have noted that private entities have created contracts which virtually takes away the independence of a doctor’s managements of patients,” said Chow.
These contracts would cover issues relating to the types of medicine that can be given, the conditions in which the patients are allowed to see the doctor, and procedures to adhere to.
These terms and conditions are “not necessarily in the best interest of the patients,” said Chow.
He said these contracts should be deemed “illegal” as under the Private Health Care Facilities and Services Act (PHFSA) 1998, all private healthcare providers, its board of management and its doctors, are required to comply with the Malaysian Medical Council’s (MMC) Code of Professional Conduct.
“If a doctor signs such a contract, he naturally breaches the law, too, and is liable for prosecution,” said Chow.
He added that FPMPAM has received reports alleging that some private hospitals, and third party payers may have policies that contravene the code of conduct of the MMC.
“It should not be allowed,” said Chow, and urged that from now on, all contracts should be sent to the Medical Practice Division in the Health Ministry to be vetted, which should be the proper procedure.
Business-driven contracts
Chow said medication has become more commercialised over the years.
“Today, medical care is being touted as a lucrative business commodity to be bought and sold, with corporate visions of exponential growth and billion-dollar turnover,” he said.
“In the current healthcare scenario, the basic needs of patients and the aspirations of compassionate doctors are no longer a contractual priority.
“Instead, the turnover generated by doctors and their corporate patients has become the implicit driver of business-driven contracts,” he said.
“At end of the day, who is going to protect the rights of the patients?” asked Chow.
He said that what is worse is that the healthcare facilities management would even terminate doctors who become “whistleblowers” and bring up such issues.
Citing a local case, Chow said one doctor was sacked by the management of a private hospital when he reported the wrongdoings of the hospital to the MMC.
“The said doctor then sued the hospital for wrongful termination and the court subsequently found that the hospital had acted wrongfully,” said Chow.
One Dr Milton Lum, a gynaecologist and a former Malaysian Medical Association president, had in 2009 sued Assunta Hospital for damages and loss of income after it terminated his contract.
Lum had alleged that he was terminated following a complaint he made to MMC against another doctor for breach of confidentiality.
The High Court, on Nov 30 last year, ruled that Lum’s termination as unlawful, not done in good faith or in the interest of the medical profession.
The hospital was ordered to pay RM15,000 in costs.
“We cannot have doctors with integrity who raise such matters to the authorities end up being sacked,” said Chow.
“Doctors also should not breach the MMC’s code of conduct. If they’ve already signed contracts unknowingly, FPMPAM will defend these doctors, including giving legal help,” he added.
“FPMPAM calls on all parties to always ensure that patients’ rights and interests are paramount and desist from policies and/or directives that contravene the MMC’s code.
Monday, December 19, 2011
Employers Urged To Introduce Employee Assistance Programme
Making the call, member of the Mental Health Promotion Advisory Council, Tan Sri Lee Lam Thye said such module has been proven to be effective in enhancing productivity and performance among employees.
"Mental health issues, particularly stress-related issues, among Malaysian employees are a serious matter which should be given attention so that problems such as depression and other mental health issues can be addressed," he said in a statement.
Productivity depended much on the mental health of employees, he added.
"Neglecting the mental health and psychosocial aspects in the workplace not only detrimental to the workers but also has bearing on the overall efficiency of an organisation," he said, adding that mental health promotion was in line with the country's aspiration to become a developed nation.
Mental illness contributed to the increase in global suicide rate, with one death recorded every 40 seconds, he added.
In Malaysia, the suicide rate has increased to between 19 and 20 persons for each 100,000 population compared to eight in 1980.
"No single country or individual is spared of mental health issues. This should be given attention just like any other health problems," he said.
Liow: Extended hours for people to seek medical help nationwide
Health Minister Datuk Seri Liow Tiong Lai said the hours were extended from 5pm to 9.30pm on weekdays. They will also be open on Saturdays now, from 8am to noon.
“We started with extending the hour of 16 health clinics. This received good response from the rakyat. We then increased the number to 60 clinics nationwide this year,” he told reporters after launching Karnival Ampang Sihat here yesterday.
Following this, Liow said he had achieved one of his key performance indicators (KPIs) as the country's Health Minister after reaching the targeted number of clinics with extended hours.
However, he said the ministry needed to cover more ground as there were a total of 800 government health clinics in the country.
“We still need more manpower to cover the extra shifts. We are currently trying to implement this in stages.
“Should the people need certain clinics to be opened longer, they can inform the ministry,” said Liow.
He added that the ministry would be sending more nutritionists and dieticians to public health clinics to tackle the problem of obesity among the people.
On the medicine shortage at Malacca Hospital due to the ministry's alleged failure in releasing its yearly allocation, Liow said all ministry allocations have been distributed to hospitals.
“I have asked ministry officials to take serious action on those who delayed in ordering the stock of medicine. If such problems occur, it must be rectified as soon as possible,” he said.
On the increasing cost of treatment for non-communicable diseases (NCDs), Liow admitted that the costs would keep rising because of escalating prices of medicine and medical equipment.
“We need to curb NCDs at its root cause. The ministry has met with food manufacturers to discuss health aspects and conducted campaigns to increase public awareness in fighting NCDs,” he said.
Malaysia adheres to European Union’s level of 25% TPC for oil, says Liow
He said the country adhered to the European Union's level of 25% Total Polar Compound (TPC).
The TPC is used largely to measure the quality of the oil and does not necessarily indicate how safe it is for consumption, he added.
Liow said the ministry would, however, go after offenders who have been distributing and selling recycled cooking oil as new to members of the public at grocery stores and supermarkets.
“We can take action under the Food Act 1983. We are very serious about this. We don't want anything hazardous to enter the market,” he said when asked to comment on an expose by The Star yesterday, which quoted experts as claiming that 19 brands of cooking oil sold in 1kg packets were found to have been made from recycled cooking oil obtained from hotels and restaurants.
They said the oil, if used repeatedly, could lead to hypertension, liver damage andcould potentially be carcinogenic in nature.
Health director-general Datuk Seri Dr Hasan Abdul Rahman urged the public to not be alarmed over the issue, adding that the ministry's officers were constantly monitoring the situation, including checking the entire supply chain in the production of cooking oil.
He noted that the purity of cooking oil needed to be measured using the various analysis parameters set under the Food Regulations 1985 and does not hinge purely on TPC.
“Every manufacturer must be registered and have a food safety system in place as required under the Food Cleanliness Regulations 2009.
“The Health Ministry will make sure the raw materials used, post-harvesting, transportation, manufacturing, packaging and sale are placed under control,” he added.
Dr Hasan said in a statement that laboratory tests done by the ministry found that TPC levels in cooking oil remained below the maximum permissible level even after it was used 40 times for frying.
Meanwhile, Domestic Trade, Cooperatives and Consumerism Minister Datuk Seri Ismail Sabri Yaakob has offered to help the Health Ministry run tests on the 19 brands of cooking oil allegedly made from recycled cooking oil.
His deputy Datuk Tan Lian Hoe said the Malaysian Palm Oil Board was responsible for issuing licences to recycled-oil manufacturers for products that are not used for human consumption, such as animal feed and industrial applications to make soap and candles, among others.
Guideline to control food advertisement next year
Health Minister Datuk Seri Liow Tiong Lai said the guideline was ready but the ministry was having final consultations with industry stakeholders before it could be released and implemented next year.
Speaking to reporters after a dialogue with 35 food manufacturers, Liow said the ministry would encourage the food industry to self-regulate before drafting regulations to govern the advertising and marketing of food products.
“We will only consider drafting regulations if industry players do not comply with the guideline,” he said.
Quoting the guideline for the advertisement and nutrition information labelling of fast food as an example, Liow said the fast food industry had followed the guideline and labelled their food accordingly since it was implemented a few years ago.
With this new guideline, Liow hoped that the industry would practice “responsible marketing” and provide specific details for food advertisers and marketers.
At the same dialogue, the Health Ministry has also formed a technical working group with the Federation of Malaysian Manufacturers Food Manufacturing Group to implement the commitments made by the participating manufacturers.
The manufacturers have committed to increase the production and promotion of healthy food choices, adopt an active role in multi-sectoral partnerships with the ministry and participate in non-communicable disease (NCD) prevention and control programmes.
A recent healthy survey by the ministry had revealed that NCDs like hypertension and diabetes were on the rise in the country since 1996.
Cry for help
Forty per cent of the children calling the helpline had symptoms of psychosocial and mental health problems.
Of the 5,127 calls that Childline received since its launch on Nov 20 last year, 2,044 were from children who were bored, lonely, stressed or depressed, with some even having suicidal tendencies.
Some were as young as 4 — most were latchkey kids.
“It’s worrying because it is a reflection of parental neglect somewhere along the line. If a child calls a stranger to talk about what is bothering him, then he is obviously not communicating with his parents or someone he can trust.
“It is not a good sign. It shows that they have no one else to turn to as their parents or those around them are not giving them the support they need,” Childline Malaysia chairman Sabri Abdul Rahman told the New Sunday Times.
He said the majority of calls to Childline came from children seeking support for depression, loneliness, emotional neglect, stress and boredom.
Some are in the care of siblings who may be just slightly older, as they come from families who cannot afford childcare services. And when these children are left to fend for themselves, they often feel fear and anxiety. Some of the children are bored or lonely and call 15999 just to chat with someone.
These calls reinforce the findings of the Health Ministry's Third National Health and Morbidity Survey 2006 that the prevalence of psychiatric morbidity in children and adolescents aged between 5 and 15 had risen from 13 per cent, to 20.3 per cent in 10 years.
Stress related to poverty, poor parenting, deplorable living conditions, bullying, exposure to domestic violence, sexual abuse, divorce in the family, death of a parent, discrimination and other hardships have all been linked to mental health problems.
Sabri said children who were subjected to abuse and violence made up the second largest group of callers to 15999, with 1,054 callers. In these cases, the nearest district Welfare Department office was immediately alerted.
He said the encouraging response to this helpline for children and the support provided brought hope to many children in the country.
"We are happy with the response because from not having a line, we now have 5,000-odd children calling us to talk about their problems. Even if one child is removed from an unsafe environment or offered assistance, we are happy."
The Childline support officers are trained to handle the calls and help allay the fears of children with words of encouragement and advice. Sometimes, the callers are referred to non-governmental organisations that can help counsel them.
The Malaysian Children TV Programme Foundation, of which Sabri is chairman, is financing the Childline team, for the promotion and outreach to children while the Women, Family and Community Development Ministry provides financing for the 15999 call centre.
Childline Malaysia works closely with the United Nations Children's Fund.
Childline, which is affiliated to Child Helpline International, complements the existing 15999 Talian Nur helpline.
While Talian Nur is a helpline for victims of domestic violence or other forms of abuse, children calling the helpline will automatically be diverted to a Childline support officer.
Sabri stressed that the aim of Childline was to empower and encourage children to speak up about their problems.
For next year, Childline Malaysia plans to go big in the new media to connect with a wider group of children.
"Children these days are IT savvy, so, we want to get into this space and connect with them on their rights and on safety issues via Twitter and Facebook. We are working on a Child Online Protection awareness campaign with DiGi and Cyber Security to promote this helpline in schools and we hope to engage more telcos in this programme next year.
"We are also working with other NGOs, parent-teacher associations and groups like Teach For Malaysia where we conduct workshops on children's rights and child protection so that they can take it to the schools."
Mercy Malaysia To Set Up Representative Office In Medan
Its president, Datuk Dr Ahmad Faizal Mohd Perdaus said the establishment of the office would enable aid to be distributed systematically and comprehensively as Mercy had been channelling aid to the country since 10 years ago.
"The setting up of the Medan office is still being discussed with the Indonesian government and a plan is afoot to set up another Mercy representative office in Jakarta to carry out humanitarian programmes.
"It is high time that we spread our wings and step up our capacity in humanitarian efforts, especially in healthcare provision and preparedness so that we will be more resilient in the long run," he told reporters here Saturday.
Earlier, Dr Ahmad Faizal signed a memorandum of understanding (MoU) on 'Mother, Babies and Children Healthcare' on behalf of Mercy with the North Sumatra Health Services Department which was represented by its head, Dr Kustinah Mkes.
The MoU is aimed at raising awareness on mother and baby healthcare through systematic method and medical practices as Indonesia (particularly North Sumatra) recorded the third highest maternal and infant mortality rates in Asean.
Dr Ahmad Faizal said Mercy also donated RM240,000 to four districts involved in the programme, namely Medan, Langkat, Asahan and Serdang Bedagai, which would benefit 109,442 expectant mothers and 99,493 babies.
Present were Malaysian consul-general in Medan Norlin Othman, Regent of Serdang Bedagai H.T Erry Nuradi, Mercy deputy president Norazam Abu Samah and Mercy secretary-general Raja Riza Shazmin Raja Badrul Shah.
Friday, December 16, 2011
Urgent issues for Higher Education Ministry
I agree that deteriorating standards among housemen are partly due to their attitude. However, a large part of the blame lies with the Higher Education Ministry and public universities. Poor attitude had existed among medical students since the early days of medical education in Malaysia. Then, they were identified and given proper guidance while still at university so that they emerged responsible doctors, because medical education then was a sort of apprenticeship. These days, the sheer number of students and the lack of suitably qualified medical lecturers make individual attention virtually impossible and the learning experience diluted.
Teaching in public universities for more than 20 years has given me a firsthand perspective of the downward spiral of the standard of medical schools in Malaysia. Many fellow lecturers who are experts in their disciplines quit universities to establish their own practices. They were replaced by recently graduated and inexperienced doctors and foreign lecturers from countries like Myanmar, Indonesia and Pakistan. In the past, specialists from the Health Ministry (MOH) would join universities as lecturers while medical officers would join as trainee lecturers. In the last two years, even local doctors have stopped joining universities as lecturers or trainee lecturers.
There are a few reasons for this, the most important being the salary inequality between doctors working in MOH hospitals and those who are lecturers in public universities. This began in March 2009 when Prime Minister Datuk Seri Najib Razak announced a new career pathway with time-based promotion for MOH doctors, giving them an instant increase in salary. This caused a disparity of salaries between the two categories – most marked when comparing a doctor at the MOH (RM6,731.54) with a trainee lecturer at a public university (RM4,907.57), both of the same seniority.
Another reason is the lack of transparency in the promotion of medical lecturers. Some who have worked more than 10 years are still senior lecturers while some junior lecturers have been promoted to associate professors within five years. In contrast, all MOH doctors automatically get promoted after a number of years’ service.
To rub salt into the wound, foreign lecturers at public universities are paid more than locals and most are appointed as associated professors or professors despite being less qualified. Better qualified expatriate doctors would have been appointed as lecturers in countries like the UK, US or even Singapore. A majority of foreign doctors in our public universities are those who have been unsuccessful in their applications to these countries.
In his letter, the director-general of health said the Malaysian Medical Council has set the standard in the recognition of universities offering medical programmes. However, many universities still do not meet these standards. In a recent report by the Malaysian Qualifying Agency, the university at which I currently work failed to conform to these standards.
A lack of urgency by the Higher Education Ministry in addressing these issues will have dire consequences. The next generation of doctors will no longer be the professionals we once held in high esteem. They are going to be the ones caring for us in our old age and our lives will be in their hands.
Retiring Professor
via email
New diseases not identified soon enough for remedies to be taken, says Unimas don
Dean of the Faculty of Medicine and Health Sciences of Universiti Malaysia Sarawak (Unimas) Tan Sri Professor Dr Mohd Taha Ariff said this was important as many emerging diseases were not identified soon enough for further action to be taken.
“Most of the outbreaks were identified only after they have reached major proportions.
“So, there is a need to develop a sentinel surveillance as well as inter-country surveillance infor- mation systems. At the same time, there is also a need to update the list of notifiable diseases,” he said in his keynote lecture entitled “Responding to Health Crisis from Infectious Diseases Outbreak” at the second International Symposium on Zoonoses and Emerging Infectious Diseases at Unimas yesterday.
Taha is a former director of the Health Ministry’s Disease Control Division.
He said there was also a need to set up an outbreak preparedness plan to counter the next impending outbreak.
“We need to develop strategies to address the outbreak at pre-crisis, crisis and post-crisis levels.
“At the same time, the laboratory services must be improved where new and unusual organisms must be reported while cross-references are made within domestic and international levels,” he added.
During an outbreak, he said, communication also played an essential part in dealing with the crisis.
“It is important for the authority to be transparent and officers must be properly trained in disseminating information.
“Training must also be provided to strengthen public health resources and social mobilisation,” he said.
He added that there was also a need to improve networking where new findings and experiences could be shared among consultants.
Health crisis, he said, occurred due to human, animal and environmental factors, among other things.
“Lack of utilities and clean water and rural-urban migration are contributing to the crisis too. The transmission of diseases through the thriving vectors also plays a part,” he explained.
He added that the crisis had given a direct health burden on morbidity and mortality as well as psychosocial impact.
“It has also resulted in losses of income to family, community and nation.
“Politically, transboundary relationship may also be affected,” he said.
Merging healthcare sectors a wrong move
Over the last few decades, both sectors have been developing and flourishing at an amazing pace, so much so that Malaysia can be a model of good healthcare to the developing – and even developed – nations.
The private healthcare sector has grown in an exemplary way, with a few giant healthcare providers taking a major share of the industry. Development and progress continue together with the health industry, boosted by the participation of individual and corporate payors.
Many of the major private healthcare centres can proudly boast of facilities and services equal to that of Western nations. The private healthcare service is currently serving a significant number of both the local and expatriate population, all for a fairly reasonable annual premium.
Today, it is not only the rich who purchase such policies, but also the average income earner, and even some government servants who want to enjoy good healthcare, especially during an emergency.
In the government sector, we have seen an equally impressive growth of healthcare facilities – rural healthcare centres, district hospitals and major city and town hospitals (previously known as general hospitals), sprouting across the length and breadth of the country, providing one of the best government supported healthcare services in the world.
Why change the equilibrium? Why introduce an unknown, untested and possibly unworkable system of healthcare for everyone?
The private sector is already in an excellent state, with various centres fulfilling Quality Care ISO 9000 and JCI standards. The subscribers are happy, and the providers are happy, and healthcare financiers, too, are flourishing.
It must therefore be the government sector that needs to be revamped, improved and revitalised, rather than merging the two into one.
Taking a smaller excellent private healthcare service and merging it with a massive government organisation is certainly not the way to produce excellence.
I believe that the Cabinet with its wisdom and its primary role of serving and protecting the public will not proceed with 1Care 1Malaysia, but maintain a good two-provider system, while pushing the Health Ministry to do better and be as good as the private healthcare sector, which is also mainly owned by the government and its affiliated bodies.
I vote “No!” to 1Care 1Malaysia, but being a pensioner, I say “Yes!” to better government healthcare services!
Dr K.H. SNG,
Kuala Lumpur.
Rising NCD figures in health survey alarming, says Liow
Health Minister Datuk Seri Liow Tiong Lai, who revealed the findings yesterday, said the results could be traced to the unhealthy lifestyle and dietary habits of Malaysians.
“The figures show that there is an increase in non-communicable diseases (NCDs), from obesity to diabetes and high blood pressure, and this trend is alarming,” said Liow.
“Only 7.5% of Malaysians follow the WHO recommendation of taking five servings of vegetable and fruits every day, and only about 64.8% exercise,” he added.
Despite aggressive health awareness campaigns, 15% of Malaysians are obese (1% up since 2006) and almost half of all adult Malaysians are overweight or obese.
More than three in 10 Malaysians have high blood pressure (0.5% up from 2006) and about one in five Malaysians over 30 are now diabetic (6% up from 2006).
Over the last 15 years, more children between ages five and nine were also found to have mental health issues.
The survey estimates that about one in 20 children in that age range has some form of mental health problem. The same trend is also found in teenagers aged 15 to 16.
This worrying trend had prompted the Health Ministry to step up its efforts to deal with NCDs.
Its latest effort is to expand the focus of its existing Communication for Behavioural Impact (Combi) programme for dengue to also include community education about NCDs.
With this new focus, the ministry has appointed three 1Malaysia Health Ambassadors TV presenter Aznil Nawawi, radio deejay Phoebe Yap and talk show host Uthaya Kumar Gopal to encourage Malaysians to adopt healthy lifestyles.
This came after a Cabinet committee involving nine ministries was set up in October to tackle NCDs at policy level.
“We realise that we cannot tackle this problem alone,” said Liow, who announced earlier that the target of this Cabinet committee is to reduce the prevalence of NCDs by 15% in the next 10 years.
Thursday, December 15, 2011
Malaysia the first Asian country to use stroke medication Read more: Malaysia the first Asian country to use stroke medication
Malaysia has become the first country in Asia and the third in the world to approve rivaroxaban for this purpose, said Dr Axel Bouchon, General Manager for Bayer HealthCare in Malaysia, Singapore and Brunei.
He said National Pharmaceutical Control Bureau of the Ministry of Health Malaysia gave the approval recently, shortly after approvals by the United States and Ukraine.
In a statement here today, Bouchon said the US-FDA recommends rivaroxaban for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF).
"AF-related stroke can be prevented with proper diagnosis, treatment and management. With the approval, Malaysian patients who are living with AF can be among the first in the world to benefit from rivaroxaban, which also has potential to help reduce the devastating burden that strokes have on patients and their families," he added.
Datuk Dr Azhari Rosman, consultant cardiologist with the National Heart Institute, said in the same statement that approval of rivaroxaban offers physicians a new option to effectively reduce stroke-risk in patients who are living with atrial fibrillation and the continous threat of strokes.
An estimated 40,000 Malaysians succumb to stroke each year, making it the third largest cause of death in Malaysia, after heart disease and cancer, and also the most common cause of severe disability, the statement said.
Toxorhynchites Can Reduce Aedes Mosquitos
This is possible as the larvae of Toxorhynchites consumes the larvae of the aedes mosquitoes, he said.
"Dengue is one of the world's biggest threats which kills more than 22,000 people every year.
"The Subang Jaya Municipal Council (SJMC) is collaborating with Universiti Sains Malaysia (USM) to contain the threat by releasing Toxorhynchites," he told reporters after opening a local authority environmental health conference here Wednesday.
He hoped other local authorities would follow suit to undertake the same approach.
Meanwhile, SJMC health director Dr Roslan Mohamed Hussin said Toxorhynchites were first released in 2010 with the approval of the Health Ministry.
The process was carried out in two stages, with 200 pairs released each time, he said.
Dr Roslan said SJMC managed to reduce the threat in the municipality by 70 per cent this year.
"The Toxorhynchites do not suck blood, only the nectar of plants, aside from eating the aedes larvae," he assured.
Wednesday, December 14, 2011
Malaysian patients spend RM700mil on kidney dialysis yearly
Health director-general Datuk Seri Dr Hasan Abdul Rahman said most of the 23,000 cases involving kidney failure could have been prevented if people take care of their health and doctors identify high-risk patients early.
“The prevalence of kidney disease is 15% and that means 4.1 million Malaysians are likely to have the disease.
“The cost of kidney dialysis is RM33,000 a year per patient,” he said after launching the first Clinical Practice Guidelines on Management of Chronic Kidney Disease (CKD) in Adults yesterday.
Dr Hasan said those with the disease may not have obvious symptoms and sometimes detection came too late.
Earlier, he told medical personnel to know the number of patients to expect and identify them.
He said that those with hypertension and diabetes, for instance, need not suffer from kidney damage if they detect their condition early and get treated.
Dr Hasan said RM3mil would be spent on training doctors on the new guidelines next year.
National Nephrology Services head Datuk Dr Ghazali Ahmad said RM760mil was spent a year on dialysis.
He also said that the amount did not include medicine costs borne by patients.
“More than 14,000 patients need kidney transplants and some have gone out of the country to source for kidneys and this has led to Malaysians being accused of being involved in human trafficking,” he said.
Dr Ghazali said that another RM50mil was spent on medication after transplantation.
He also said more medical personnel were needed to treat kidney patients each year.
Tuesday, December 13, 2011
Malaysians Visiting Thailand Should Get Health Insurance Policy
This advice from Malaysian Consul-General in Songkhla Mohd Aini Atan comes in the wake of many Malaysian tourists under the misconception it was sufficient to enter Thailand with just valid travel documents and vehicle insurance.
He said they did not pay much attention to medical treatment which they might seek at a Thai hospital.
Mohd Aini quoted a case where a Malaysian tourist had to cough up over RM90,0000 to settle medical fees at a hospital in Thailand after being involved in a road accident.
Among others, the fees covered medical treatment and admitance to the hospital's intensive care unit.
"The family of the victim had asked for our help to pay the bills, but we could not help much in such a financial matter," he told Bernama after meeting with Perlis Border Cooperation Committee chairman Ahmad Bakri here today.
Mohd Aini said medical charges incurred by Malaysians at overseas hospitals should be borne by them.
"That is why, Malaysians should get a health insurance policy before travelling abroad.
Meanwhile, Ahmad said Perlis and Thailand's southern provinces, especially Songkhla and Satun, were committed in strengthening ties through various bilateral activities, including the friendly football tournament which was held in Satun last Friday.
He said a meeting to enhance Perlis-Satun bilateral cooperation and discuss possible development in the Malaysia-Thailand border was held at the Satun Governor's Office on Dec 9.
The Perlis delegation was led by Menteri Besar Datuk Seri Dr Md Isa Sabu while Satun's delegation was led by Satun Acting Governor Nueachai Jirahapirak.
In the two-hour meeting, both parties had also agreed to revive a plan to develop Bukit Batu Puteh near Kuala Perlis as a new entry point that would connect Perlis and Satun.
The plan to develop Bukit Batu Puteh was first made in 1996 but the project was hampered by technical problems.
Mobile eye clinic for rural folk next year
Minister Datuk Seri Liow Tiong Lai said Saturday the clinic, which would cost RM1mil, would also arrange for patients to be treated and operated upon at local hospitals.
“This will improve the people's accessibility to such services,” he told reporters after a visit to the Tun Hussein Onn National Eye Hospital mobile eye clinic, which provided its services at the Bentong Health Clinic here.
He said the mobile eye clinic would have an optometrist while treatment and operations at local hospitals would be performed by visiting ophthalmologists.
Liow said in Malaysia, about 2.7% of the population or 783,000 people suffered from visual impairment.
“The major cause of visual impairment in the country is refractive errors (43.7%), followed by cataracts (36.3%),” he said.
As for blindness, he said, the prevalence in Malaysia was estimated to be about 0.3% or 87,000 people.
However, he said, only about 64,000 blind people were registered with the Welfare Department last year.
He said the common causes of blindness in Malaysia included cataract (40%), retinal disease (24.5%), uncorrected refractive error (4.1%), corneal disease (3.4%) and glaucoma (1.8%).
Liow said currently, there were 350 ophthalmologists in the country, including 182 with the ministry.
He added that the ministry was also recruiting 40 doctors into the Masters programme in ophthalmology at Universiti Kebangsaan Malaysia, Universiti Sains Malaysia and Universiti Malaya every year.
Liow: Imported products tested and cleared of radioactive contamination
Liow was responding to media reports that manufacturer Meiji Holdings Co had recalled 400,000 tins of Meiji Step baby formula from Japanese markets after it was found to be contaminated by radioactive material.
Meiji is based in Saitama Prefecture, Japan. Its factory is located about 200km from the Fukushima Daiichi nuclear plant, where damaged reactors experienced a meltdown following the March 11 quake and tsunami.
According to reports, the contaminated milk powder contained 22-31 becquerel (bq) of the radioactive materials Cesium-134 and Cesium-137 per kg.
“The Health Ministry wants to make clear that the (Meiji Step) baby formula has not been imported into Malaysia,” Liow said.
According to Liow, this was based on information he had received from the Food Safety Information System of Malaysia (FoSim).
He added that all food imported from areas in Japan that were at risk from radioactive contamination, including Saitama Prefecture, underwent Pemeriksaan Tahap 5 (Tahan, Uji & Lepas) as part of FoSim’s procedure.
“Through this examination process, samples from the food consignments are analysed for radioactive contamination.
“The consignment is cleared only if the sample complies with safety standards,” Liow said.
He added that if members of the public still had doubts about the safety of any food product, they could make a report to the Health Ministry at their nearest district health office (PKD) or state health department (JKN).
Alternatively, they could do so online at the ministry’s website at http://fsq.moh.gov.my/v3
Wednesday, December 07, 2011
Easing medical ad rules
This will also allow the country to better compete with its neighbours as one of the health hubs in the region.
Health Minister Datuk Seri Liow Tiong Lai said health practitioners had appealed to the Government for a review of the guidelines because they were losing out on medical tourists.
“Although doctors and hospitals are now allowed to advertise their services, there are certain limitations,” he said. “We will review this and see how it can further boost the health industry.”
Currently, among others, health practitioners cannot claim to be the best providers of a particular treatment and are not allowed to use too many personal photographs to promote themselves.
Speaking to reporters after opening the Chief Executive Officer Summit for Malaysian Healthcare Travel here yesterday, Liow said a review was also timely because many healthcare services offered in the country were already of world-class standard.
“Since healthcare travel has been identified as one of the entry point projects to generate greater income and create new jobs, this will be considered,” he said.
He also added that nearly two million medical tourists bringing in some RM4bil to the country’s gross national income by 2020 was expected.
Liow said in the first nine months of the year, some 350,000 foreigners, most of whom were Indonesians, spent RM380mil for treatment in Malaysia.
“However, despite a 22% annual growth between 2004 and last year, Malaysia’s share of the healthcare pie is still very small, compared to Singapore and Thailand.
“We certainly can go further if we put in the right strategies and concerted efforts,” he said, adding that the revenue target was some RM430mil this year.
The ministry, he said, would also be setting up call centres in China and Indonesia next year to attract more medical tourists.
Hospitals in Malacca out of medicine
State Health, Project Rehabilitation, Suburban Development and NGO committee chairman Datuk Seet Har Cheow assured the patients that the problem would be resolved by tomorrow.
“The shortage of medicine has placed patients in a limbo. The state is addressing the situation,” he said, adding that new supplies had been dispatched.
“We expect things to normalise in a day or two.”
Seet blamed the shortage on “several inevitable factors” but said the state was in constant touch with the Health Ministry.
“I can’t divulge these factors. But I strongly dismiss allegations that medical personnel were hoarding the drugs and secretly supplying these to private pharmacies,” he said, adding that the ministry was putting in place measures to prevent a recurrence.
Asked if the quality of the medicine would be compromised in the rush to stock up, Seet said: “Health isn’t something we gamble with.”
In Putrajaya, Health Minister Datuk Seri Liow Tiong Lai said the shortage should be dealt with immediately by the respective administrators.
He, however, was not aware of the situation in Malacca.
“It was not reported to me, but it shouldn’t have happened,” he said, adding that he had reminded all hospital and clinic administrative staff members to ensure there was enough stock.
“Although hospitals and clinics can sometimes run out of medicine at the end of the year, they should have a plan to prevent it from happening,” he said.
Malacca Pensioner Associations chairman J. Ram said its 2,000 members, who relied heavily on public hospital medicine, had been left in the lurch.
“Even pharmaceutical products to treat high-blood pressure patients were unavailable for almost a month,” he said.
“Many of us are elderly patients who cannot afford to get supplies from private pharmacies.”
12,000 waiting for kidney transplants
The figure was revealed to reporters by chairman of the Organ Donation Awareness Promotion Action Committee, Tan Sri Lee Lam Thye recently.
“The number of patients in the country on the waiting list for organ transplant is so great. For kidneys alone, there are more than 12,000,” he said.
Anyone could imagine the agony of having to wait that long for a kind donor to save them.
As such, Lee felt the need for his committee, under the Ministry of Health, to put more effort into getting more Malaysians to register as organ donors.
“Regard this donation as a charity and as a showcase of a truly caring society in the country,” he said.
He stressed that for most transplants, the organs must come from cadaveric sources.
The lack of cadaveric donors is largely due to attitude, mindset, prejudice, misconception and preconceived ideas on organ donation.
There are no legal or religious obstacles, and there is consensus on brain death which is essential to cadaveric organ retrieval.
“There are no major ethical issues in cadaveric transplants,” Lee said.
What was essential was to continuously disseminate information and motivate people of all races, colour and creed to donate organs.
Lee was in Miri to officiate at the `Organ Donation Promotion Campaign for Sarawak’ roadshow held at the National Youth Skills Institute (IKBN), Bandar Baru Permyjaya.
It was organised by the State Health Department in collaboration with the said committee.
No illegal kidney trade here
Health Minister Datuk Seri Liow Tiong Lai told The Malay Mail police had conducted a thorough investigation and found no basis for the allegations made by authorities in Bangladesh three months ago.
“The Inspector-General of Police (IGP) submitted the report of the investigation to me last month and it confirmed the accusation as baseless. There is no truth to it,” Liow said.
He said the investigation was based on police reports lodged by the National Kidney Foundation and the Nefrologist Association here.
“This is an allegation that came from nowhere.” he said.
On Sept 22, Bernama had reported that Malaysia was among several countries in the radar of the Bangladeshi police, who were on the trail of an international syndicate linked to illegal Bernamakidney trade across several Southeast Asian countries.
The report said investigators had identified a reputable international hospital with branches in key regions and capitals, including a hospital in Selangor which was allegedly involved in the trade.
Initial investigations had revealed that donors from remote villages in Bangladesh were apparently flown to the regions to sell their kidneys.
The report said eight people have been arrested in connection with luring the poor, illiterate victims overseas for the purpose.
The report had quoted Joypurhat Superintendent of Police, Mozammel Haque, as saying that an agency in Dhaka was involved in the illegal kidney transplant targeting not just the poor and illiterate but people in debt.
He claimed each victim was paid between US$2,000 (RM6,000) and US$3,000 for a kidney, but was unsure how much the organ was priced in the black market.
So far, at least seven cases of illegal kidney sale have surfaced in Joypurhat, located in northern Bangladesh, where largely impoverished communities survive on seasonal agricultural crops.
On Sept 27, the Health Ministry had reportedly said they would work with the Home Ministry and the police to investigate the allegation.
Health director-general Datuk Dr Hasan Abdul Rahman had said the ministry was taking the matter seriously, and upon finding any relevant evidence on the claims, would not hesitate to take serious action.
Dr Hasan had said as a member of the World Health Organisation and signatory to the Declaration of Istanbul on Organ Trafficking and Transplant Tourism, Malaysia was committed to ensuring illegal organ trade did not take place in the country.
He had also said kidney transplants in Malaysia were currently performed specifically at Kuala Lumpur Hospital, Selayang Hospital, University Malaya Medical Centre and a few private hospitals in the Klang Valley.
It had seemed far-fetched for such an illegal activity, especially involving foreigners, to have been conducted in any of the said hospitals, he added.
Monday, December 05, 2011
Call for MMA to hold fresh polls
Doctors, including past presidents, are also asking for a caretaker committee to be formed to conduct the elections, claiming that the six-month period given by the Home Ministry for the body to put its house in order is meaningless because its next AGM would have been due by then.
Former president Datuk Dr Lee Yan San said since MMA's May election had been declared null and void by the Home Ministry, it should immediately conduct a postal ballot and allow members to pick a new team.
“The council should also function without its president-elect as the May election has been annulled,” he said.
The Home Ministry had on Nov 30 directed the 10,000-member MMA to call for fresh elections after it found that the body had contravened electoral procedures during its election in May.
The ROS struck off the body on Nov 16 for failing to satisfactorily reply to a show-cause letter on the violations, including the failure to send out the complete list of candidates vying for positions and for distributing an incomplete agenda for the AGM.
The MMA notified members on its website that it would continue to function normally until its next AGM in May.
Former president Datuk Dr P. Krishnan said the current principal office bearers should automatically cease to hold office.
“They should be denied access to MMA headquarters, which contains valuable information including data on membership and indemnity insurance, fixed deposits and bank cheque books,” he said.
Dr Krishnan, who had previously served as its general-secretary, said MMA's constitution provided for other members of the council, including its current president and immediate past president to convene and fill up the posts vacated by the five principal office bearers.
Former Penang MMA chairman Dr S. Indran claimed that the present exco should be answerable for proceeding with the election although it was fully aware that the ROS was investigating it for alleged irregularities, adding that the most honourable thing was for them to resign en bloc.
Former general secretary Dr A. Rajamohan said an extraordinary meeting should be held and new leaders brought in to helm the body.
Keeping an eye on eyes
DOES it surprise you to know that the most common cause of visual loss, including blindness, among working adults in Malaysia is actually preventable?
And as it is a condition that arises as a consequence of having another disease, it is actually preventable on two levels.
The medical condition we are talking about is diabetic retinopathy, which is one of the leading complications from having diabetes mellitus, or more commonly known as just diabetes. As a non-communicable disease, caused by mainly lifestyle factors, diabetes is preventable by living a healthy lifestyle.
However, as it stands at the moment, the Third National Health and Morbidity Survey in 2006 estimated that 14.9% of Malaysians aged 30 and above have diabetes. This means that in a group of around seven adults, one is likely to be diabetic.
And this number is only expected to increase, with the International Diabetes Federation predicting that the number of diabetes patients in Southeast Asia will double by 2025.
If that was not bad enough, the 2007 Diabetic Eye Registry Malaysia reported that over one third of diabetic patients (36.8%) have diabetic retinopathy. Of these, 15.6% had sight-threatening retinopathy, with 9% practically blind already.
Catch it early
Now, there are two important things to bear in mind concerning diabetic retinopathy.
Firstly, it is an almost inevitable consequence of having diabetes. The longer you are diabetic, the more likely you are to develop diabetic retinopathy.
According to the World Health Organisation (WHO), around half of diabetic patients will have some sort of diabetic retinopathy after 10 years, while almost all patients with type 1 diabetes mellitus and over 60% of patients with type 2 diabetes mellitus (the more common variety) will have some degree of retinopathy after 20 years of having diabetes.
Secondly, diabetic retinopathy can be reversed in the early stages of the condition.
However, there are no symptoms during that early stage, and by the time the patient starts having symptoms of the condition — like floaters (dark spots that float across your field of vision), blurred vision, missing areas of vision, and trouble seeing at night — it is already too late to reverse the damage.
That is why it is essential that diabetic patients go for regular eye check-ups once they have been diagnosed, so that any problem with the eyes can be caught at the stage when it is still reversible.
According to Health director-general Datuk Dr Hasan Abdul Rahman, “Late presentation with irreversible blindness continues to be a major challenge in the management of diabetic retinopathy in Malaysia.”
Looking at the numbers from the 2007 Diabetic Eye Registry, around 70.9% of diabetic patients have never gone for an eye examination before.
And this is despite the recommendation that all type 2 diabetes patients (comprising 92% of the entries in the registry) should get their eyes examined as soon as they are diagnosed.
Bigger and better
Dr Hasan made the statement in conjunction with the launch of the Clinical Practice Guidelines (CPG) for the Screening of Diabetic Retinopathy at Hospital Selayang recently.
As can be inferred from its name, the CPG is the latest and most updated set of guidelines for healthcare professionals on the best screening procedure for diabetic retinopathy.
As diabetic patients are followed up by general practitioners and non-eye specialists, it is crucial that these healthcare professionals are aware of the proper method to monitor for diabetic retinopathy.
According to Hospital Selayang consultant ophthalmologist, and head of the committee that put together the CPG, Dr Nor Fariza Ngah, this edition of the CPG contains far more information than its predecessor.
“The 1996 CPG was a simple one. Now, we have a new classification, new scheduling for follow-ups, and it is very evidence-based, from both local and international resources,” she said.
The contents of this CPG include the risk factors for diabetic retinopathy; a standardised grading for the severity of the disease; recommendations on screening methods, including sample fundus images; the recommended examination and follow-up schedules, including when to refer to an ophthalmologist; and treatment options.
Also included is a list of the 107 government clinics that have a fundus camera — the recommended screening tool for diabetic retinopathy.
A slim booklet of 35 pages, the CPG is aimed at all frontline healthcare professionals, including nurses, assistant medical officers, optometrists, general practitioners and family medicine specialists.
Dr Hasan said during his speech: “I ask two things: number one, to make sure these guidelines are internalised and institutionalised by all our personnel.”
He added that he expects the CPG to be treated as a “bible” in the monitoring of diabetic patients for retinopathy.
“Number two, another thing towards institutionalisation is that we must incorporate this CPG into all our teaching hospitals; put it into the curriculum,” he said, adding that he is taking the implementation of the guidelines very seriously.
“There is no point having a guideline if it is not practised,” he said.
The CPG is also meant for private practitioners.
Dr Hasan said that doctors in the private sector can get it for free from the ministry’s Health Technology Assessment Section in Putrajaya, or download it from the ministry’s website (http://www.moh.gov.my/v/op).
It begins with you
HIV and AIDS awareness programme, It Begins With You, recently made further inroads by reaching out to the people of Kota Bharu in conjunction with World AIDS Day 2011.
The Kota Bharu initiative, which was spearheaded by healthcare company MSD, and the Malaysian Society for HIV Medicine (MaSHM), was supported by the Kelantan Health Department, Prihatin, SAHABAT, Kolej Kejururawatan, and the medical, nursing and pharmacy students from Hospital Universiti Sains Malaysia.
Commenting on this latest initiative, Ewe Kheng Huat, managing director of MSD, said, “It is timely that It Begins with You spreads its wings beyond the Klang Valley as we are acutely aware of the need for education and awareness of HIV and AIDS in other regions.
“As much as we have witnessed positive responses in the Klang Valley over these last six years, we look forward to seeing how the Kota Bharu initiative will also contribute to lives being changed, perspectives challenged, and, more importantly, to sow the seeds of commitment among future doctors and healthcare professionals in Kota Bharu.
“We are indeed pleased to be able to launch It Begins with You in Kota Bharu and reach out to the community there. It has been great to see the enthusiasm of our partners – their dedication and excitement are certainly infectious and encouraging. They have rallied together to set out a good HIV and AIDS outreach programme, and we applaud each of them,” Ewe added.
Dr Mahiran Mustafa, President of MaSHM and advisor to Prihatin, said: “From 1986 up to 2010, 91,362 HIV-positive cases have been reported, with 12,943 of these lives lost. While HIV treatment has become more accessible to patients, the number of HIV-positive people continues to increase, signaling a dire need for education, especially for healthcare professionals, in order for us to have the right perspective and fully understand the social and healthcare implications for people living with HIV (PLHIV). This is so that we can accord them the respect and care they need.
“One of the key reasons why we are raising awareness on HIV and AIDS in Kelantan is because the state records one of the highest incidences of new infections for HIV. According to figures from the Health Ministry, in Kelantan alone, there were 9,891 HIV-positive patients at the end of December 20092. The increasing number of reported new HIV infections needs to be addressed,” said Dr Mahiran.
The Kota Bharu initiative comprised programmes such as educational visits to a shelter home and support centre by the medical, nursing and pharmacy students, spearheaded by Prihatin and SAHABAT, as well as a public event at Kota Bharu Mall to drive the awareness on HIV and AIDS.
The event was launched by Dr Wan Mansor bin Hamzah, the deputy director of the Kelantan State Health Department.
Highlights of the It Begins With You event in Kota Bharu Mall included HIV quizzes for the public to enhance their understanding on HIV and AIDS, a board for public pledges in support of the cause, and a resident clown to entertain the crowd.
Other interesting activities included a colouring competition for children, as well as dikir barat and wayang kulit performances with HIV themes.
It Begins With You was first initiated in 2005 to address the low ratio of doctor to HIV-patient, by raising awareness among medical students of the dire need for more HIV and AIDS treaters. It also seeks to address the stigma associated with the interaction and treatment of people living with HIV and AIDS (PLHIV).
The programme continually invites resources and expertise of partner organisations to address these issues and positively impact the lives of PLHIVs. Previous advocacy initiatives included participation of medical students from various universities, namely International Medical University, Universiti Teknologi MARA, Universiti Malaya and Universiti Putra Malaysia.
To continue support towards these universities, HIV initiatives such as a HIV talk and a HIV awareness run were held at the International Medical University in conjunction with their HIV Week in October and November this year.
Better healthcare for all
MALAYSIA aspires to become a high-income nation by 2020. The Government Transf-ormation Programme and the Economic Transformation Program-me, formulated and implemented in the 10th and 11th Malaysia Plan, provides the platform to achi-eve this goal.
The health sector is not excluded from this wave of improvements. 1Care for 1Malaysia is the proposed transformation plan to restructure the healthcare system so that quality services will be provided to the population based on the principle “use according to need, pay according to ability”.
As Malaysia moves towards a high-income nation status, more healthcare services will be needed. This is to cover the requirements of a larger population; higher life expectancy resulting in greater numbers of elderly; changes in disease patterns with more chronic illnesses; advances in medical technology and higher client expectations.
Therefore, private investments and the continuous contribution of the private sector are encouraged. However, with the existing healthcare financing situation, greater private health sector development would widen the gap of access to healthcare services for the rural population compared to the urban population; and between those who can and cannot afford to pay.
Under the 1Care for 1Malaysia plan, everyone, regardless of his ability to pay, has the choice to use either public or private healthcare.
Greater emphasis will be given to strengthen primary health services, with a fundamental focus on promotive and preventive care. Using the family doctor concept, every person will register with a family doctor of his choice for his primary care needs. This doctor can be from the public or private sector. Patients will not incur any charges when receiving care from their doctor for services within the defined benefits package. However, patients may be charged a small co-payment for prescriptions and certain appliances.
Patients requiring specialist care or hospitalisation will be referred by their family doctor. This will promote optimal use of specialists and hospital services for those who really require higher level care. When referred, patients may choose to go to a government or private hospital. Patients do not have to make any additional payments for specialist services and hospitalisation that are within the defined benefits package.
To support the health service delivery reforms, the health financing system must also be transformed to pool together different sources of funding for health; better manage the nation’s health funds; and control dramatic rises in healthcare costs.
Currently, Malaysia’s health system is funded by two sources.
Government and private funding account for 55% and 45% of total health expenditure, respectively.
Public funding comes from Government General Revenue, while private funding includes out-of-pocket spending (OOP), private health insurance and financing by employers.
The Malaysia National Health Accounts estimated that the country spent RM33.7bil for health in 2009. This was less than 5% of Malaysia’s Gross Domestic Product (GDP) and lower than the OECD average of 9.7%.
Healthcare cost escalation is an issue that has been voiced more frequently in recent years.
Global evidence shows that as a country becomes richer, its healthcare spending grows faster than GDP growth. In 13 years, from 1997 to 2009, Malaysia’s total health expenditure increased at an average of 12-13% per year, higher than general inflation.
If there is no health financing reforms, Malaysia’s health spending is estimated to reach RM102bil by 2020. This increase will be borne more by individuals and families, through OOP spending and private health insurance.
The proposed health financing transformation is a combination of Government General Revenue and Social Health Insurance (SHI). It involves pooling contributions from the self-employed, employees, employers and the Government.
Emphasis is given on the shared responsibility of individuals, families, communities, the corporate sector and the Government to fund the costs of healthcare services together. This consolidated fund will be managed by a government organisation responsible to the Health Ministry.
Currently, there are patients who are not able to pay their healthcare bills, especially when obtaining services from the private sector. The existing system of financial risk protection is inadequate and so patients may bear a high burden of healthcare cost. Through SHI, this problem can be addressed with regular smaller pre-payments. Therefore, catastrophic spending through OOP payments, at the point of seeking care when ill, can be reduced.
SHI contributions are dependent upon the financial ability of each family. Through cross-subsidy, the rich, young and healthy contribute towards the needs of the less fortunate, elderly and sick.
The vulnerable and poor will still remain protected through government financing for the same package of benefits. Delivery of public subsidy to identified target groups will be more transparent, fair and equitable.After many years of close scrutiny, deliberations with stakeholders and feedback from various quarters, the ministry presented the concept paper on 1Care for 1Malaysia to the Prime Minister and members of the Economic Council on Aug 11, 2009. A follow-up report presented on March 22 last year provided additional information and feedback.
Consequently, the ministry received the mandate to develop the 1Care blueprint over these two years.
The blueprint will work out broad implementation steps for a comprehensive approach to the transformation process.
It will also identify strategies to tackle key issues that are anticipated including an effective strategic communication plan to better communicate progress and gather constructive feedback.
Currently, 11 Technical Working Groups have been formed to provide suggestions, technical input and knowledge on the 1Care blueprint content. Several committees oversee the development of the blueprint and provide guidance and policy directions to this effort.
Various stakeholder consultations have been and are being conducted to get input and concerns, as well as update progress.
These include workshops, seminars and research on various components of the health system transformation. They foster much needed capacity-building and understanding among key stakeholders.
The ministry is also engaging a group of experts to assist in the detailed development of this transformation process by bringing global knowledge and experience in areas which Malaysia has little expertise.
This will ensure that the blueprint addresses the multiple aspects of a comprehensive health sector transformation effort to enhance the quality of life of Malaysians.
In addition to improving the health status of the population, 1Care for 1Malaysia will also promote social solidarity and equity in healthcare.
In line with the country’s aspiration to become a developed nation, the transformation of the health system, through the sharing of health resources, is imperative to fulfil the needs of the people.
Saturday, December 03, 2011
Suggestion for MMA re-election
This follows the recent decision by the Home Ministry to give MMA six months to put its house in order if it wants to overturn a Nov 16 order by the Registrar of Societies (ROS) to de-register the association.
Dr Krishnan said the six-month period was “too long”.
“Since MMA has violated its constitution, the office bearers must relinquish their posts as soon as possible and cannot run MMA’s day-to-day affairs,” he said, adding that association president Dr Mary Suma Cardosa was wrong to leave the matter to the next “normal” election.
Another former MMA president, Dr Milton Lum, said the time period given for the association to resolve its issues was reasonable.
“What MMA needs to do is go to ROS and humbly asks where it went wrong and get an official list of what needs to be done.”
Another MMA member said that legally, the office bearers could not do anything they liked during the six-month period and members would also not let them do what they liked.
Dr Cardosa had said in the MMA website that the association was no longer de-registered as of Nov 25, following the announcement to defer the ROS’ decision by six months.
“This decision means that MMA can resume normal functions until the next AGM in May next year when the next election of office bearers will be held in full compliance with MMA’s constitution,” she said, adding that the letter from the ministry did not state that a re-election must be held.